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Gifford W, Rowan M, Dick P, Modanloo S, Benoit M, Al Awar Z, Wazni L, Grandpierre V, Thomas R, Sikora L, Graham ID. Interventions to improve cancer survivorship among Indigenous Peoples and communities: a systematic review with a narrative synthesis. Support Care Cancer 2021; 29:7029-7048. [PMID: 34028618 PMCID: PMC8464576 DOI: 10.1007/s00520-021-06216-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/09/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE The purpose of this systematic review is to synthesize the evidence on the types of interventions that have been utilized by Indigenous Peoples living with cancer, and report on their relevance to Indigenous communities and how they align with holistic wellness. METHODS A systematic review with narrative synthesis was conducted. RESULTS The search yielded 7995 unique records; 27 studies evaluating 20 interventions were included. The majority of studies were conducted in USA, with five in Australia and one in Peru. Study designs were cross-sectional (n=13); qualitative (n=5); mixed methods (n=4); experimental (n=3); and quasi-experimental (n=2). Relevance to participating Indigenous communities was rated moderate to low. Interventions were diverse in aims, ingredients, and outcomes. Aims involved (1) supporting the healthcare journey, (2) increasing knowledge, (3) providing psychosocial support, and (4) promoting dialogue about cancer. The main ingredients of the interventions were community meetings, patient navigation, arts, and printed/online/audio materials. Participants were predominately female. Eighty-nine percent of studies showed positive influences on the outcomes evaluated. No studies addressed all four dimensions of holistic wellness (physical, mental, social, and spiritual) that are central to Indigenous health in many communities. CONCLUSION Studies we found represented a small number of Indigenous Nations and Peoples and did not meet relevance standards in their reporting of engagement with Indigenous communities. To improve the cancer survivorship journey, we need interventions that are relevant, culturally safe and effective, and honoring the diverse conceptualizations of health and wellness among Indigenous Peoples around the world.
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Affiliation(s)
- Wendy Gifford
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
| | - Margo Rowan
- Rowan Research and Evaluation, Ottawa, Ontario, Canada
| | - Peggy Dick
- Algonquins of Pikwakanagan Health Services and Family Health Team, Pikwakanagan, Ontario, Canada
| | - Shokoufeh Modanloo
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Maggie Benoit
- Algonquins of Pikwakanagan Health Services and Family Health Team, Pikwakanagan, Ontario, Canada
| | - Zeina Al Awar
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Liquaa Wazni
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Viviane Grandpierre
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian D Graham
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Ontario, Canada
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Tan N, Cho H. Cultural Appropriateness in Health Communication: A Review and A Revised Framework. JOURNAL OF HEALTH COMMUNICATION 2019; 24:492-502. [PMID: 31132946 PMCID: PMC7101074 DOI: 10.1080/10810730.2019.1620382] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
A revised framework for cultural appropriateness is offered on the basis of a systematic review of operationalizations in 44 cancer screening interventions for Asian Americans. Studies commonly conveyed the epidemiological bases of the intervention (97.7%) and used the language of the population (95.5%). Less commonly reported were strategies central to health communication: cultural features of the intervention messages (77.3%) and the cultural beliefs and values that the intervention focused on (43.2%). Few used cultural tailoring (4.5%) and none aimed to address acculturation or cultural identity. The theoretical framework most frequently used was the health belief model (27.3%) which does not explain the role of culture. More studies focused on cultural barriers (20.5%) than cultural strengths (9.1%). Our revised framework comprises six cultural appropriateness strategies of cultural identity, linguistic, perceptual features, content, constituent-involving, and socioeconomic context-adaptive. It prioritizes cultural identity to recognize the dynamics within racial ethnic groups and to inform adaptive efforts for cultural appropriateness. It emphasizes examining cultural strengths that can facilitate change, as well as reducing cultural barriers. Future research and action should address the disparities in extant health disparities research in which theory and methods are underdeveloped and underutilized for Asian Americans.
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Hohl S, Molina Y, Koepl L, Lopez K, Vinson E, Linden H, Ramsey S. Satisfaction with cancer care among American Indian and Alaska Natives in Oregon and Washington State: a qualitative study of survivor and caregiver perspectives. Support Care Cancer 2016; 24:2437-44. [PMID: 26638004 PMCID: PMC4846546 DOI: 10.1007/s00520-015-3041-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To better understand satisfaction with care among American Indian and Alaska Native (AI/AN) persons with cancer, we explored dimensions of the provider relationship that contributed to satisfaction among caregivers and survivors who received cancer treatment in Oregon and Washington State. METHODS Between November 2011 and April 2013, the project team interviewed 11 caregivers and 71 AI/AN cancer survivors residing in Oregon and Washington State. Interview questions aimed to elicit participant experiences with care providers and factors associated with cancer care satisfaction. Interviews were analyzed using an inductive content analysis approach in which concepts were identified and themes derived from interview data. RESULTS Three overarching themes, each with two sub-themes, emerged from the data: (1) universal factors: bolstering understanding, involvement, and empathy in care; (2) minority-specific factors: incorporating culture and community into care; and (3) AI/AN-unique factors: interacting with Indian health clinics and Indian Health Service (IHS). CONCLUSIONS The results of our study suggest that satisfaction with care among survivors and their caregivers must be examined within the context of culture and community, particularly among minority patients. Our study demonstrates providers' critical role in ensuring AI/AN patients emerge satisfied with cancer treatment by honoring their AI/AN-specific needs, such as respect for integration of traditional healing modalities and navigation of specialty care coordination.
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Affiliation(s)
- Sarah Hohl
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA.
- School of Public Health, Department of Health Services, University of Washington, Seattle, WA, USA.
| | - Yamile Molina
- School of Public Health, Center for Research on Women and Gender, Cancer Center, University of Illinois-Chicago, Chicago, IL, USA
| | - Lisel Koepl
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA
| | - Kerri Lopez
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Eric Vinson
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Hannah Linden
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA
- Seattle Cancer Care Alliance, Seattle, WA, USA
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Scott Ramsey
- Fred Hutchinson Cancer Research Center, Public Health Sciences Division, 1100 Fairview Avenue N.M3-B232, Seattle, WA, 98109, USA
- School of Medicine, University of Washington, Seattle, WA, USA
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Langdon SE, Golden SL, Arnold EM, Maynor RF, Bryant A, Freeman VK, Bell RA. Lessons Learned From a Community-Based Participatory Research Mental Health Promotion Program for American Indian Youth. Health Promot Pract 2016; 17:457-63. [PMID: 27009131 DOI: 10.1177/1524839916636568] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background American Indian (AI) youth have the highest rates of suicide among racial/ethnic minority groups in the United States. Community-based strategies are essential to address this issue, and community-based participatory research (CBPR) offers a model to engage AI communities in mental health promotion programming. Objectives This article describes successes and challenges of a CBPR, mixed-method project, The Lumbee Rite of Passage (LROP), an academic-community partnership to develop and implement a suicide prevention program for Lumbee AI youth in North Carolina. Method LROP was conducted in two phases to (1) understand knowledge and perceptions of existing mental health resources and (2) develop, implement, and evaluate a cultural enrichment program as a means of suicide prevention. Discussion/Results LROP implemented an effective community-academic partnership by (1) identifying and understanding community contexts, (2) maintaining equitable partnerships, and (3) implementing a culturally tailored research design targeting multilevel changes to support mental health. Strategies formed from the partnership alleviated challenges in each of these key CBPR concept areas. Conclusions LROP highlights how a CBPR approach contributes to positive outcomes and identifies opportunities for future collaboration in a tribal community. Using culturally appropriate CBPR strategies is critical to achieving sustainable, effective programs to improve mental health of AI youth.
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Affiliation(s)
| | | | | | | | - Alfred Bryant
- University of North Carolina, Pembroke, Pembroke, NC, USA
| | | | - Ronny A Bell
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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Filippi MK, Perdue DG, Hester C, Cully A, Cully L, Greiner KA, Daley CM. COLORECTAL CANCER SCREENING PRACTICES AMONG THREE AMERICAN INDIAN COMMUNITIES IN MINNESOTA. JOURNAL OF CULTURAL DIVERSITY 2016; 23:21-27. [PMID: 27188017 PMCID: PMC4990452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality. Effective prevention and early detection may be achieved through screening, but screening rates are low, especially in American Indian (AI) populations. We wanted to understand perceptions of CRC screening among AI located in the Great Lakes region. Focus groups were recorded and transcribed verbatim (N = 45). Data were analyzed using qualitative text analysis. Themes that deterred CRC screening were low CRC knowledge, fear of the procedure and results, cost and transportation issues, and a lack of quality and competent care. Suggestions for improvement included outreach efforts and culturally-tailored teaching materials.
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Watanabe-Galloway S, Burhansstipanov L, Krebs LU, Harjo LD, Petereit DG, Pingatore NL, Isham D. Partnering for success through community-based participatory research in Indian country. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:588-595. [PMID: 25030416 PMCID: PMC4142145 DOI: 10.1007/s13187-014-0683-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Shinobu Watanabe-Galloway
- Epidemiology Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4395, USA
| | - Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO 880470-7830 USA
| | - Linda U. Krebs
- College of Nursing, University of Colorado Denver, ED2N Room 4209, 13120 East 19 Avenue, P.O. Box 6511, Aurora, CO 80045, USA
| | - Lisa D. Harjo
- Native American Cancer Research Corporation (NACR), 3110 S. Wadsworth Blvd. Suite 103, Denver, CO 80227, USA
| | - Daniel G. Petereit
- Department of Radiology Oncology, Rapid City Regional Hospital, John T. Vucureivich Cancer 353 Fairmount Blvd, Rapid City, SD 57701, USA
| | - Noel L. Pingatore
- Inter-Tribal Council of Michigan, Inc., 2956 Ashmun St., Sault Ste. Marie, MI 49783, USA
| | - Debra Isham
- Oklahoma City Area Indian Health Service, 701 Market Drive, Oklahoma City, OK 73114. (Formerly Tobacco Prevention Program, Muscogee (Creek) Nation Division of Health, Okemah, OK)
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Lee DJ, Tannenbaum SL, Koru-Sengul T, Miao F, Zhao W, Byrne MM. Native American race, use of the Indian Health Service, and breast and lung cancer survival in Florida, 1996-2007. Prev Chronic Dis 2014; 11:E35. [PMID: 24602589 PMCID: PMC3945077 DOI: 10.5888/pcd11.130162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We evaluated associations of race, primary payer at diagnosis, and survival among patients diagnosed in Florida with lung cancer (n = 148,140) and breast cancer (n = 111,795), from 1996 through 2007. In multivariate models adjusted for comorbidities, tumor characteristics, and treatment factors, breast cancer survival was worse for Native American women than for white women (hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.05–2.20) and for women using the Indian Health Service than for women using private insurance (HR, 1.71; 95% CI, 1.33–2.19). No survival association was found for Native American compared with white lung cancer patients or those using the Indian Health Service versus private insurance in fully adjusted models. Additional resources are needed to improve surveillance strategies and to reduce cancer burden in these populations.
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Affiliation(s)
- David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, PO Box 016069 (R-699), Miami, FL 33101. E-mail:
| | - Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, Florida
| | - Tulay Koru-Sengul
- University of Miami Miller School of Medicine Department of Public Health Sciences and Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Feng Miao
- Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, Florida
| | - Wei Zhao
- Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, Florida
| | - Margaret M Byrne
- University of Miami Miller School of Medicine Department of Public Health Sciences and Sylvester Comprehensive Cancer Center, Miami, Florida
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Krebs LU, Burhansstipanov L, Watanabe-Galloway S, Pingatore NL, Petereit DG, Isham D. Navigation as an intervention to eliminate disparities in American Indian communities. Semin Oncol Nurs 2014; 29:118-27. [PMID: 23651681 DOI: 10.1016/j.soncn.2013.02.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify the role of patient navigation in decreasing health care disparities through an exemplar of a successful patient navigation program for American Indian populations living in the Northern and Southern Plains of the United States. DATA SOURCES Published literature and data from the Native Navigators and the Cancer Continuum study. CONCLUSION Native Patient Navigators successfully collaborated with local American Indian organizations to provide cancer education through a series of 24-hour workshops. These workshops increased community knowledge about cancer, influenced cancer screening behaviors, and increased the visibility and availability of the navigators to provide navigation services. IMPLICATIONS FOR NURSING PRACTICE Reaching those with health care disparities requires multiple strategies. Collaborating with patient navigators who are embedded within and trusted by their communities helps to bridge the gap between patients and providers, increases adherence to care recommendations, and improves quality of life and survival.
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Affiliation(s)
- Linda U Krebs
- University of Colorado, College of Nursing, Aurora, CO 80045, USA.
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Warren-Mears V, Dankovchik J, Patil M, Fu R. Impact of patient navigation on cancer diagnostic resolution among Northwest Tribal communities. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:109-18. [PMID: 23242563 PMCID: PMC3610770 DOI: 10.1007/s13187-012-0436-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The patient navigator model has not been widely implemented in American Indian/Alaska Native (AI/AN) communities, but may be effective in improving cancer outcomes for this population. Subjects were enrolled from eight clinics at Tribes throughout the Northwest (n = 1,187). Four clinics received navigation. Time between abnormal finding and definitive diagnosis was recorded. We examined whether odds of obtaining definitive diagnosis by 60, 90, and 365 days differed between the two groups. The odds of definitive diagnosis within 365 days for navigated subjects was 3.6 times (95 % CI, 1.47, 8.88; p = 0.01) the odds for control subjects. The outcome at 60 and 90 days did not significantly differ between the two groups. Our findings indicate that patient navigation did not significantly impact chance of diagnosis by 60 or 90 days from abnormal finding. However, it did improve the chance of avoiding extreme delays in obtaining a definitive diagnosis.
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Affiliation(s)
- Victoria Warren-Mears
- Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, Oregon 97201
| | - Jenine Dankovchik
- Northwest Tribal Cancer Navigator Program & NW IDEA Project, Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR 97201, Ph# 503-416-3265, Fax # 503-228-8182,
| | - Meena Patil
- Northwest Tribal Cancer Navigator Program, Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, Oregon 97201, Ph# 503-416-3265, Fax # 503-228-8182,
| | - Rongwei Fu
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, Ph# 503-494-6069,
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Burhansstipanov L, Clark RE, Watanabe-Galloway S, Petereit DG, Eschiti V, Krebs LU, Pingatore NL. Online evaluation programs: benefits and limitations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:S24-S31. [PMID: 22447646 PMCID: PMC3544411 DOI: 10.1007/s13187-012-0320-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Patient navigation programs are increasing throughout the USA, yet some evaluation measures are too vague to determine what and how navigation functions. Through collaborative efforts an online evaluation program was developed. The goal of this evaluation program is to make data entry accurate, simple, and efficient. This comprehensive program includes major components on staff, mentoring, committees, partnerships, grants/studies, products, dissemination, patient navigation, and reports. Pull down menus, radio buttons, and check boxes are incorporated whenever possible. Although the program has limitations, the benefits of having access to current, up-to-date program data 24/7 are worth overcoming the challenges. Of major benefit is the ability of the staff to tailor summary reports to provide anonymous feedback in a timely manner to community partners and participants. The tailored data are useful for the partners to generate summaries for inclusion in new grant applications.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO 80470-7830, USA,
| | - Richard E. Clark
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO 80470-7830, USA,
| | - Shinobu Watanabe-Galloway
- Epidemiology Department, College of Public Health, 984395 University of Nebraska Medical Center, Omaha, NE 68198-4395, USA,
| | - Daniel G. Petereit
- Department of Radiology Oncology, Rapid City Regional Hospital, John T. Vucurevich Cancer, 353 Fairmont Blvd, Rapid City, SD 57701, USA,
| | - Valerie Eschiti
- OUHSC College of Nursing, 1100 North Stonewall Ave, CNB 453, Oklahoma City, OK 73117, USA,
| | - Linda U. Krebs
- College of Nursing, Anschutz Medical Campus, University of Colorado at Denver, Box C288-18, ED2N Room 4209, 13120 East 19th Avenue, Aurora, CO 80045, USA,
| | - Noel L. Pingatore
- Inter-Tribal Council of Michigan, Inc, 2956 Ashmun St., Sault Ste. Marie, MI 49783, USA,
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